Measure Threatens Primary Care Programs, Says Academy

The AAFP has expressed concerns about the fiscal year (FY) 2014 funding allocation adopted by the House Committee on Appropriations, saying it could damage the nation's primary care infrastructure by making deep cuts in primary care physician training and research programs. The Academy urged the committee to instead adopt the FY 2014 funding allocation proposed by the Senate Committee on Appropriations, which provides a higher spending cap.

In a June 18 letter to House Appropriations Committee Chair Harold Rogers, R-Ky., and ranking member Nita Lowey, D-N.Y., AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., said the FY 2014 funding allocation for labor, education and HHS programs adopted by the committee could dramatically reduce funding for Title VII, Section 747 of the Public Health Service Act and the Agency for Healthcare Research and Quality (AHRQ), among other programs.

Section 747 of Title VII is the only federal program that provides funds specifically to academic departments and programs to increase the number of primary care health professionals.

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The AAFP says a fiscal year (FY) 2014 funding allocation adopted by the House Committee on Appropriations threatens primary care research and physician workforce training programs.

In a letter to the committee, AAFP Board Chair Glen Stream, M.D., M.B.I., said the FY 2014 allocation for labor, education and HHS programs could result in dramatic funding reductions for Title VII, Section 747 of the Public Service Act and the Agency for Healthcare Research and Quality, among other programs.

Stream urged the committee to adopt the funding allocation proposed by the Senate Committee on Appropriations for FY 2014 as an alternative.

"Family physicians share your commitment to restoring the economic prosperity of this nation, and we believe that appropriate investments in the patient-centered research and primary care infrastructure will support more efficient health care for all and help tackle the long-term debt of the federal government," said Stream. "We are concerned that the House-proposed allocation will be inadequate to make the necessary investment in vital primary care research and physician workforce training."

Appropriations committees in both the House and Senate set limits, known as 302(b) allocations, for their respective subcommittees. These allocations establish the spending cap for all agencies and programs funded by the appropriations bills. Stream noted in his letter that the "House Appropriations Committee's 302(b) allocation is lower than the level provided in fiscal year 2001 and could result in further cuts to Title VII primary care training grants at a time when we should be increasing that commitment."

Saying that the AAFP remains concerned that the Budget Control Act's sequestration cuts and other across-the-board reductions already are impeding federal investments in primary care training and research, Stream urged the committee to instead adopt the FY 2014 funding allocation proposed by the Senate Committee on Appropriations, which would provide a higher cap on spending.

In the letter, Stream noted that the Academy has called for a modest increase in federal spending for AHRQ to achieve a high-functioning health care system that controls costs, reduces health disparities and delivers high-quality care.

Such research includes that conducted by AHRQ's Primary Care Practice-Based Research Networks, in which primary care physicians "expand the science base of clinical care through systematic inquiry," as well as studies by the Patient-Centered Outcomes Research Institute, which "help primary care physicians and their patients make informed health care decisions," said Stream.